Organization
UPPER CUMBERLAND UROLOGY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN V GORYL MD (PRESIDENT/PHYSICIAN OWNER)
(931) 528-5547
Entity
Organization
Contact information
Practice address
320 N OAK AVE, COOKEVILLE, TN 38501-2440
(931) 528-5547
(931) 526-2699
Mailing address
320 N OAK AVE, COOKEVILLE, TN 38501-2440
(931) 528-5547
(931) 526-2699
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2008612
BLUE CROSS BLUE SHIELD
TN
05
—
3378641
—
TN
Enumeration date
03/27/2006
Last updated
04/30/2008
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